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Rochelle Payne Ondracek, Michael W. Kattan, Christine Murekeyisoni, Changhong Yu, Eric C. Kauffman, James R. Marshall, and James L. Mohler

Background: The Kattan postoperative radical prostatectomy (RP) nomogram is used to predict biochemical recurrence-free progression (BCRFP) after RP. However, external validation among contemporary patients using modern outcome definitions is limited. Methods: A total of 1,931 patients who underwent RP at Roswell Park Cancer Institute (RPCI) between 1993 and 2014 (median follow-up, 47 months; range, 0–244 months) were assessed for NCCN-defined biochemical failure (BF) and RPCI-defined treatment failure (TF). Actual rates of biochemical failure-free survival (BFS; defined as 1 – BF) and treatment failure-free survival (TFS; defined as 1 – TF) were compared with Kattan BCRFP nomogram predictions. Results: The Kattan BCRFP nomogram predictions at 5 and 10 years were predictive of BFS (area under the receiver operating characteristic curve [AUC], 0.772) and TFS (AUC, 0.774). The Kattan BCRFP nomogram tended to underestimate BFS and TFS compared with actual outcomes. The Kattan 5-year BCRFP predictions consistently overestimated actual 5-year BFS outcomes among subgroups of high- and intermediate-risk patients with at least 5-year outcomes. Conclusions: The Kattan BCRFP nomogram is a robust predictor of NCCN-defined BF in a large sample of patients with RP with substantial follow-up and modern, standardized failure definitions

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Kelvin A. Moses, Preston C. Sprenkle, Clinton Bahler, Geoffrey Box, Sigrid V. Carlsson, William J. Catalona, Douglas M. Dahl, Marc Dall’Era, John W. Davis, Bettina F. Drake, Jonathan I. Epstein, Ruth B. Etzioni, Thomas A. Farrington, Isla P. Garraway, David Jarrard, Eric Kauffman, Deborah Kaye, Adam S. Kibel, Chad A. LaGrange, Paul Maroni, Lee Ponsky, Brian Reys, Simpa S. Salami, Alejandro Sanchez, Tyler M. Seibert, Terrence M. Shaneyfelt, Marc C. Smaldone, Geoffrey Sonn, Mark D. Tyson, Neha Vapiwala, Robert Wake, Samuel Washington, Alice Yu, Bertram Yuh, Ryan A. Berardi, and Deborah A. Freedman-Cass

The NCCN Guidelines for Prostate Cancer Early Detection provide recommendations for individuals with a prostate who opt to participate in an early detection program after receiving the appropriate counseling on the pros and cons. These NCCN Guidelines Insights provide a summary of recent updates to the NCCN Guidelines with regard to the testing protocol, use of multiparametric MRI, and management of negative biopsy results to optimize the detection of clinically significant prostate cancer and minimize the detection of indolent disease.